This application proposes to conduct a large prospective, population-based epidemiological study of the relations of the continuum of self-neglect to important health outcomes in a biracial population of older adults. The specific aims of this research are to quantify the relations of self-neglect severity to the frequency of 1) physician and home health agency visits;2) emergency room visits and hospitalizations;3) admissions to skilled nursing facilities and long-term nursing home placements;4) the risk of overall mortality;and 5) to compare the relations noted above among blacks and whites in the same community. Evidence suggests that over 1.2 million cases of elder self-neglect are reported annually in the US, more than any other forms of elder mistreatment (physical abuse, psychological abuse, sexual abuse, financial exploitation, caregiver neglect, abandonment and self-neglect). Prior research indicates self neglect in severe forms has associated morbidity &mortality, but there is very little systematic information from direct longitudinal studies to elucidate the full spectrum of self-neglect severity to adverse health outcomes, particularly the racial/ethnic differences in these health outcomes. The project will rigorously investigate these relations within the context of the Chicago Health and Aging Project (CHAP): a longitudinal epidemiologic study of a biracial population since 1993. The overall goal of this population-based study is to provide new information the consequences of elder self-neglect in a biracial population for the development of adverse clinical outcomes. The broad, long-term objective of this research is to develop strategies to identify older adults at high risk for self-neglect. Candidate is surrounded by highly successful investigators in a nurturing interdisciplinary environment. The Beeson award (K23) will permit the candidate?s rapid maturation into independent investigator and leader who will conduct clinically and policy relevant aging research.